Diagnostic and prognostic improvements in electrophysiology have been spectacular and mainly been attributable to the development of implantable cardiac devices, such as implantable cardioverter defibrillators (ICDs), cardiac resynchronization therapy pacemakers (CRT-Ps), and resynchronization therapy pacemakers with defibrillation therapy (CRT-D). These therapies are expensive because of both up-front initial implant costs and for subsequent check-up, device replacement, and possible complications. As this is a typical case in which a therapy is both costly and effective, assessment of cost-effectiveness of these device therapies becomes of paramount importance. According to recent studies, these treatments are broadly cost-effective when applied adequately and correctly analysed over a long-term period. The up-front initial cost of the devices and their implant are sometimes short-term barriers to the implementation of cost-effective therapeutic strategies.
Influence of implantable cardioverter-defibrillators on the long-term prognosis of survivors of out-of-hospital cardiac arrest.
